What Is Single Payer?

A single-payer system is a way of financing and administering health care so that equal, comprehensive, quality care is possible for everyone. A public agency organizes the financing, while delivery of care remains largely private. The public agency—the single payer—defines wide-ranging benefits, pools contributions, negotiates reasonable costs for care, and pays all medical bills.

Key features of a single-payer system include:

1. Streamlined, not-for-profit administration

2. Maximized purchasing power through negotiated prices of all services, including doctors and other health professionals, medical supplies and equipment, laboratories, hospitals, and pharmaceuticals, etc.

3. Financing from individuals paying a percentage of income, employers paying a percentage of payroll, and government funding such as Medicare, Medicaid and other safety-net health care programs

4. Uninterrupted comprehensive benefits for everyone, with coverage unaffected by changes in employment, marital status, age, income, or health condition

5. Efficient and timely payment for services and supplies


Single-payer systems, with variations, exist today in Canada, Taiwan, and the U.S. (Medicare). Most successful universal health care systems that use multiple payers (e.g. France and Germany) share the key features of single-payer, that is, no profit taken on administration for basic health care, negotiated prices, and the same comprehensive benefits for all.